| Summary: | In this age of evidence based medicine, clinicians are encouraged to identify the ulcer type and then follow well researched clinical practice guidelines. Most lower leg ulceration is venous or mixed venous/arterial aetiology but there are a few ulcers that have rarer aetiologies. This article discusses some of these more unusual ulcers that the author has seen in her years as a wound consultant -- skin cancers, Necrobiosis Lipoidica Diabeticorum, Pyoderma Gangrenosum, vasculitis, mycotic skin infections, Leishmaniasis, Meliodosis, Mycobacterium Ulcerans/Buruli ulcer, medication induced/related ulceration and thalassaemia related ulcers. Identification and treatment methods will be covered to assist clinicians with early diagnosis and aid a speedy recovery. As our communities become increasingly more global, aetiologies previously seen only in the developing world are being found in developed countries and clinicians in all areas will need to have some understanding of these other causes of lower leg ulcers.
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